It works if you manage to get around the initial setup. The Text-to-speech narrator thing crashes the game unless you figure out the right Proton version to use (i already forgot, ProtonDB might be of help). And all my joysticks have worked ootb.
Vatsim does work, i used SteamTinkerLaunch to first install the programs on the MSFS wine prefix with Onetime Run. You can use that to run the programs too before you run the game or add them to Custom Command setting to run along the game when you start it.